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. 2020 Jul 9;15(1):249.
doi: 10.1186/s13018-020-01772-w.

Patterns, management, and outcomes of traumatic pelvic fracture: insights from a multicenter study

Husham Abdelrahman  1 , Ayman El-Menyar  2   3 , Holger Keil  4 , Abduljabbar Alhammoud  5 , Syed Imran Ghouri  5 , Elhadi Babikir  5 , Mohammad Asim  6 , Matthias Muenzberg  4 , Hassan Al-Thani  7
Affiliations

Patterns, management, and outcomes of traumatic pelvic fracture: insights from a multicenter study

Husham Abdelrahman et al. J Orthop Surg Res. .

Abstract

Background: Traumatic pelvic fracture (TPF) is a significant injury that results from high energy impact and has a high morbidity and mortality.

Purpose: We aimed to describe the epidemiology, incidence, patterns, management, and outcomes of TPF in multinational level 1 trauma centers.

Methods: We conducted a retrospective analysis of all patients with TPF between 2010 and 2016 at two trauma centers in Qatar and Germany.

Results: A total of 2112 patients presented with traumatic pelvic injuries, of which 1814 (85.9%) sustained TPF, males dominated (76.5%) with a mean age of 41 ± 21 years. In unstable pelvic fracture, the frequent mechanism of injury was motor vehicle crash (41%) followed by falls (35%) and pedestrian hit by vehicle (24%). Apart from both extremities, the chest (37.3%) was the most commonly associated injured region. The mean injury severity score (ISS) of 16.5 ± 13.3. Hemodynamic instability was observed in 44%. Blood transfusion was needed in one third while massive transfusion and intensive care admission were required in a tenth and a quarter of cases, respectively. Tile classification was possible in 1228 patients (type A in 60%, B in 30%, and C in 10%). Patients with type C fractures had higher rates of associated injuries, higher ISS, greater pelvis abbreviated injury score (AIS), massive transfusion protocol activation, prolonged hospital stay, complications, and mortality (p value < 0.001). Two-thirds of patients were managed conservatively while a third needed surgical fixation. The median length of hospital and intensive care stays were 15 and 5 days, respectively. The overall mortality rate was 4.7% (86 patients).

Conclusion: TPF is a common injury among polytrauma patients. It needs a careful, systematic management approach to address the associated complexities and the polytrauma nature.

Keywords: Hemodynamic instability; Mortality; Pelvic fracture; Tiles’s classification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram showing study design
Fig. 2
Fig. 2
Distribution of a associated injuries and b concomitant injured regions with pelvic fracture (n = 885)
See this image and copyright information in PMC

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